THE RULES AND REGULATIONS' OF ' j 7 THE PUBLIC HOSPITAL, UNDER THE 5th SECTION OF THE PUBLIC HOSPITAL LAW, No. 12 OF 1869. JAMAICA : GOVERNMENT PRINTING ESTABLISHMENT, 1881. * *»>•' ■:../£.4L£*«8E£: NATIONAL LIBRARY OF MEDICINE $ NLM DD13MDfl5 5 :^.-J# F NLM001340855 'i—\ kSr^»% Ja^.^a, L-*u;s( S+t + ^e*; ^C THE RULES AND REGULATIONS OF THE PUBLIC HOSPITAL, UNDER THE 5th SECTION OF THE PUBLIC HOSPITAL LAW, No. 12 OF 1869. ->••>-•<- JAMAICA : GOVERNMENT PRINTING ESTABLISHMENT. 1881. 3a%u ARMED FORCES MEDICAl LIBRARY WASHINGTON. D. C. INDEX. Assistant Clerk Assistant Dispenser Assistant Dresser Assist ah t Warden Assistant Night Gateman Bbdmaker Bathman Chief Medical Officeu and Director Chaplain Clerk and Purveyor Carpenter Closet Cleaner Dispenser Dispensary Apprentices Dresser Day Gateman General Rules Head Nurses Head Cook and Assistant .... Junior Resident Medical Offi-cer Labourers Ministers of Religion Medical Staff Medical Students Matron Messenger Mason Nurses in Training Night Nurses Night Gateman Official Visitors Office Cleaner Porter Patients Resident Medical Officers Senior Medical Officer Senior Resident Medical Officer Scourers Store aian Under Nurses Visitors to Patients Warden and Issuer THE BULKS AND REGULATIONS OF THE PUBLIC HOSPITAL UNDER THE 5TH SECTION OF THE PUBLIC HOSPITAL LAW, NO. 12 OF 1869. Chief Medical Officer and Director. 1. The Superintending Medical Officer for the time being shall be the Chief Medical Officer and Director. 2. He shall exercise control over the Institution and be responsible to the Governor for the administration of the Hospital in all its details. 3. As Accounting Officer he will render accounts of all sums received and disbursed in such manner as the Government may from time to time direct. Medical Staff. 4. The Medical Staff shall consist of— A Senior Medical Officer A Senior Resident Medical Officer, and A Junior Resident Medical Officer who shall be subordinate to the Chief Medical Officer and Director. Senior Medical Officer. 5. The Senior Medical Officer shall be responsible to the Chief Medical Officer and Director for the proper treatment of all patients in Hospital. 6. He shall attend at the Hospital daily at 10 a.m. (Sundays ex- cepted when he shall visit at 1 p.m.) to examine and admit applicants for admission. 7. He shall also attend in all cases of emergency when summoned by the Medical Officer on duty. 8. He shall visit the Wards daily to examine and direct the treat- ment of patients. During this visit he will be accompanied by the Resident Medical Officers to whom he shall communicate the neces- sary instructions for the Medical and Surgical management of the cases in the Wards; all instructions respecting Medical treatment, 6 diet and discipline, shall be entered at the time on the Medical His- tory Sheets. 9. He shall also be responsible for the correct keeping of the sta- tistical records by the Registrar, and shall satisfy himself that the Medical History of all patients is properly recorded by the Medical Officer in charge of each case. It will be his duty to see that the Resident Medical Officers perform their duties efficiently. 10. He shall not engage in private practice but may attend in consultation with other professional gentlemen, provided such does not interfere with his hospital duties ; he shall not undertake any duty unconnected with the Hospital without the sanction of the Chief Medical Officer and Director. Senior Resident Medical Officer. 11. The Senior Resident Medical Officer shall, in addition to his general duties, be also the Medical Registrar of the Hospital; he shall write up the Register daily and shall, under the supervision of the Senior Medical Officer, keep such statistical and other notes and tables as may be determined by the Chief Medical Officer and Di- rector. 12. The Register shall contain the following particulars in sepa- rate columns :— No. Date of Admission Name Age Colour Whence came Occupation Country Religion Disease Result Discharged Died No. of days in Hospital Remarks 13. He shall be responsible for the safe keeping of the Official Medical Records, and shall not permit the removal of any of them from the Hospital without the sanction of the Chief Medical Officer and Director. 14, On every alternate morning at 9 o'clock a.m. he shall lecture to the Medical and Dispensary Pupils on Pharmacy, Elementary 7 Chemistry and Materia Medica and allot them such studies in these subjects as he may think desirable. Junior Resident Medical Officer. 15. The Junior Resident Medical Officer shall in addition to his general duties have charge of the drug store, and shall examine and initial all requisitions for and returns of medicine, and submit same for the approval of the Chief Medical Officer and Director. He shall also have charge of and be responsible for the safe keeping of all surgical instruments, and other apparatus belonging to the Hos- pital, and he shall not allow any instrument to be lent without the express sanction of the Chief Medical Officer and Director. Resident Medical Officers. 16. The Resident Medical Officers may not engage in private prac- tice, their entire time must be considered at the disposal of the Institution ; they shall act under the direction of the Senior Medical Officer, and will be held responsible for the proper treatment of the patients admitted to their special charge respectively. 17. They shall perform residential duty alternately, relieving each other at 7 o'clock a.m. daily, and shall attend any emergency sum- mons from the Hospital without hesitation, whether on or off duty. 18. The Officer on residential duty shall visit all the Wards at uncertain hours during the day and night, each visit being duly re- corded in the Ward Journals; his night visit should not be made before 8.30 p.m. During his tour of duty he shall be always pre- sent either in the Hospital or at his Quarters. 19. On the admission into Hospital after the usual taking-in hour of any severe or dangerous accident case, or any serious case of ill- ness, the Medical Officer on duty shall without delay report the cir- cumstance to the Senior Medical Officer and record it in the book kept for the purpose, for the information of the Chief Medical Officer and Director. 20. In the unavoidable absence, from sickness or otherwise, of one or other of the Resident Medical Officers they shall render each other mutual assistance in the performance of their duties. 21 The Resident Medical Officers shall commence their ordinary daily duties at 7 a.m. They shall visit the Wards of the Hospital and examine the patients under their charge every morning before the visit of the Senior Medical Officer and before 5 p.m. in the after- noon of the same day; they shall also visit, prescribe for, and record the condition on admission of those patients entrusted to their care. The first visit in the morning shall be entered in the Attendance Book which is kept at the Porter's Lodge. 8 22. The Resident Medical Officers shall not absent themselves from the Hospital during the hours of day duty without the sanction of the Chief Medical Officer and Director, or in his absence of the Senior Medical Officer. 23. They shall not discharge any patient from the Wards, without the sanction of the Chief Medical Officer and Director, or of the Senior Medical Officer, the cause of such discharge to be entered in the Ward Journal at the time. 24. They shall carefully and fully record the Medical History of every patient admitted to their care, and shall be held responsible that the bed head tickets of such cases are properly filled in. 25, They shall attend and perform all post-mortem examinations at 3 p.m., or as soon after that hour as their other duties will per- mit, and shall record in the Medical History Sheet the post-mortem appearances as soon after the examination as possible. 26. The Resident Medical Officers shall attend the out-patients on Mondays, Tuesdays, Thursdays and Fridays at noon, or as soon after that hour as their other duties will permit. 27. The Resident Medical Officers shall not perform any surgical operation without the concurrence of the Senior Medical Officer, ex- cept the usual minor operations, cr in cases of extreme emergency. Medical Officers. 28. The Medical Officers shall decline to admit as an in-door patient any applicant whom they may not consider entitled to gra- tuitous medical aid, unless a guarantee is given for the payment of hospital dues. 29. They shall have power to refuse admission to any person suf- fering from any contagious or infectious or otherwise loathsome disease, should they consider that proper means for segregation do not exist. 30. It shall be optional with the Medical Officers to refuse any person applying for admission, but the reason for so doing shall be entered in a book to be kept for the purpose, together with the name, date, sex, residence, disease, and cause of rejection. 31. They shall bring to the notice of the Chief Medical Officer and Director any matter affecting the proper care or treatment of the patients, or the good order, sanitary condition and discipline of the Institution. All cases of neglect of duty, inattention to orders or misconduct on the part of any of the Students, Sub-Officers, Nurses or Servants of the Hospital, shall be duly recorded in the Officers Report Book, which is in charge of the Porter, for the information of the Chief Medical Officer and Director. 9 32. They shall enter in the Ward Journal every case of miscon- duct on tho part of patients, for which punishment by alteration of diet has been inflicted, but no punishment shall be resorted to with- out tho sanction of the Chief Medical Officer and Director. 33. All ordinary surgical operations shall be performed in the Operating Theatre on Wednesdays and Saturdays at 2 p.m., when the Resident Medical Officers shall be present. Board of Visitors. 34. The Board of Visitors shall meet once a quarter, or oftener if necessary, at the Institution, and inspect and examine the books and accounts thereof, if they shall think fit to do so, and inspect the Wards, Stores, and every other place, and the liquors and pro- visions and medicines in Store, and shall draw up and transmit to the Governor such reports and returns as they shall from time to time deem necessary, or which the Governor may call for in respect of any matter relating to the said Institution. 35. The Chairman may, on his own authority, or shall on the re- quisition of any three Members, convene a meeting of the Board at any other time of which meeting three days notice by Circular, addressed by the Clerk to each Member, stating the particular ob- ject of the meeting, shall be given. 36. In the absence of the Chairman at any meeting of the Board, the Members present shall elect one of their own body to act as Chairman pro-tempore. 37. At the first meeting in each year a Roster of duty of the Members of the Board of Visitors, as a Visiting Committee, shall be fixed by the Board. 38. The Board of Visitors shall have power to suggest such al- terations in the Rules and Regulations of the Institution as they may from time to time think necessary, for submission, by the Chief Medical Officer and Director, for the consideration of the Governor. 39. A book shall be kept at the Institution, to be called the Visitors Book, in which every Member of the Board of Visitors who shall visit the Institution shall enter the year, the day of the month and the hour on which he shall have visited the same, with any remarks he may deem necessary to make respecting any matter connected with the management or regulation of the Hospital, a copy of .all which entries shall be made and forwarded weekly to the Governor by the Clerk. 40. A Minute Book shall be kept in which the proceedings of the Board shall be entered, and a copy of the minutes shall be forward- ed atfer each sitting to the Colonial Secretary, for the information of His Excellency the Governor. 10 Medical Students. 41. Gentlemen desirous of availing themselves of the practice of the Hospital, with a view to obtain preparatory professional knowledge to fit them for the further study of the Medical Profes- sion, may be enrolled as Students on their presenting to the Chief Medical Officer and Director testimonials of good moral character, and of sufficient educational proficiency, and on their paying to the funds of the Hospital the sum of six pounds. 42. During the period of their studentship they shall be amena- ble to the Laws and Rules of the Institution, and shall be under the direct supervision and control of the Authorities of the Hos- pital. 43. Students shall attend the Hospital daily, between the hours of 7 a.m. and 5 p.m. They must be present at the morning visit of the Resident Medical Officers through the Wards ; they will also be required to attend in the Receiving Room during the examina- tion of applicants for admission, and they will accompany the Se- nior Medical Officer in his visits through the Hospital. 44. They shall also attend all post-mortem examination and sur- gical operations. They will moreover be required to assist in the Laboratory, under the Dispenser, during the hours from 2 to 4 p.m., so as to acquire a practical knowledge of the compounding and dis- pensing of drugs. 45. After six months services they shall be eligible to act as Dres- sers and Clinical Clerks, and the Medical Officers will, from time to time, select those whom they may consider best qualified to per- form such duties. 46. Students will, on no account, be permitted to visit the Wards alone, or *to interfere in any way with patients, except when acting as Clinical Clerks or Dressers as aforesaid. 47. Any infringement of this rule would necessitate tho exclusion from the Institution of the Student so transgressing. 48. Students whilst in the Hospital will be required to conduct themselves with becoming order and decorum, and their behaviour in relation to the nurses, servants, officers and patients, must be characterized by courtesy and civility. Any departure from such a course of conduct will be reported to the Chief Medical Officer and Director, who shall in the event of any repetition of unruly or im- proper behaviour exclude from the Hospital the Student so offend- ing, should such a course be considered necessary in the interests of the Institution. Chaplain. 49. The Chaplain shall on every Sunday, as also on such other 11 days of tho week as may be convenient, at 3 p.m., at the place set apart for the purpose by the Chief Medical Officer and Director, perform evening service. 50. He shall be at liberty to visit the Hospital at all hours and phall be sent for in cases of emergency. 51. He shall enter in a Journal to be kept at the Institution the date and hour of such special visits to individual patients, name of such patient, any other duties that ho may perform, and any other observations that may occur to him. , 52. He shall furnish the Chief Medical Officer and Director with a report of his services during the year, as soon after the close of the financial year as possible. Clerk and Purveyor. 53. He shall attend at the Office of the Institution from 9 o'clock a.m, until 4 o'clock p.m., Sundays excepted, for the transaction of business. He shall act as Clerk to the Board of Visitors, and shall summon all meetings of the Board under the direction of the Chair- man ; he shall attend all meetings, and take minutes of the proceed- ings thereof and shall enter them in the Visitors Minute Book. 54. He shall copy all Reports and Returns for transmission to the Government, and shall conduct the correspondence of the Board of Visitors, keeping copies of all such correspondence. 55. He shall keep, written up correctly, all the financial books of the Hospital, and shall produce them for inspection when required • to do so by the Chief Medical Officer and Director, or by any Mem- ber of the Board of Visitors. 56. He shall each morning examine and check the store books, compare the receipts and issues of all stores for the previous day with the orders or requisitions, and report immediately to the Chief Medical Officer and Director any errors, waste, extravagance, or irregularity in the supply or issue of stores. 57. He shall take charge daily of all moneys and other valuables received by the Hall Porter from patients on admission, and shall keep in a book a register of same, with the name of patient, descrip- tion and value of property. 58. He shall examine the claims of Contractors and others, and certify the correctness of the prices and rates charged before any such claims are paid. 59. He shall report from time to time to the Chief Medical Officer and Director any irregularity in the delivery of articles by Contrac- tors, or bad quality of articles supplied. GO. He shall collect all claims for Hospital dues, and furnish the Chief Medical Officer and Director with a monthly return of same. 12 61. He shall conduct the correspondence of the Hospital under the direction of the Chief Medical Officer and Director. 62. When required by the Chief Medical Officer and Director he shall assist in the performance or superintendence of any duty and make himself generally useful. ' Assistant Clerk. 63. He shall attend at the Office of the Institution daily, Sundays excepted, from 9 o'clock a.m. until 4 o'clock p.m. 64. He shall keep correctly written up for reference the Issue and Receipt Books, the Letter Book, the Semi-Official Letter Book, and perform such other clerical work as the Chief Medical Officer and Director may require. 65. He shall copy all reports, returns and letters for the signature of the Chief Medical Officer and Director. 66. He shall fill up daily the Summary of Diets. 67, He shall assist in the performance or superintendence of any duty, and make himself generally useful, Matron. 68. The Matron shall reside on the premises and not leave them without the permission of the Chief Medical Officer and Director, or in hisabsence of the Senior Medical Officer or Resident Medical Offi- cer on duty. 69. She shall visit the Wards daily, as often as practicable, and at night at uncertain periods between the hours of 6 and 10 p.m., and she shall be present at the change of Nurses at 6 a.m. and again at 6 p.m. 70. She shall report all irregularities to the Chief Medical Officer and Director. 71 She shall have the general charge of the Hospital Clothing and Bed-Linen. 72. She shall keep a register of every description of clothing and bedding in her possession, and make a monthly return of the quanti- ty and description thereof to the Chief Medical Officer and Director, according to the form prescribed. 73. She shall count out and deliver to each Head-nurse, on her re- quisition, every Saturday evening, one pair of sheets and a-pillow case, and on Saturday evenings and Thursday mornings a complete suit of clothing for each patient in every Ward, and she shall supply clean bed-linen or clothing to patients at other times when required, on the requisition of the Head-nurses of the Wards. 74. She shall receive from the Nurses, on the delivery of clean clothing, all dirty bedding and clothing, and see that the same are properly accounted for by the Head-nurses. 13 75. She shall deliver early every Monday morning, for conveyance to the General Penitentiary for the purpose of being washed, all ar- ticles of clothing and bedding, delivering therewith a list of the quantity and description, on the face of which list she shall certify the receipt of the clothing when returned clean to her possession. 76. Whenever any female patient brings into the Hospital any ar- ticles of dirty clothing she shall see that they are sent by the Head- nurses to be washed, and afterwards put up in the Clothes Room, the key of which shall be in her possession. 77. She shall have the general superintendence of all the Nurses and see that they are present and attending to their duties; that they do not leave the Hospital under any pretext, without special permission, before the hours appointed ; that they perform their du- ties carefully, and observe silence and order while discharging them; that they conduct themselves with civility towards the patients; that they prevent all traffic between the patients and persons within or without the walls ; that they keep the rooms and utensils perfectly clean, and report to her the name of any patient who infringes the Rules of the Institution ; she shall take care that the Nurses observe cleanliness in the Wards and are decently clad whilst performing their duties. Warden and Issuer. 78. The Warden who shall also be the Issuer shall open and close the store for the transaction of business, as follows :— 7 a.m. to 9 a.m. 12 noon to 12.30. 3 p.m. to 4 p.m. 79. He shall carefully examine and see weighed or measured every article sent in by Contractors or others on requisition for the use of the Institution, and shall report immediately to the dork and Pur- veyor if any article of bad quality is delivered. 80. He shall be held responsible for every article of supply that comes into the Institution, and he shall not deliver anything without a proper requisition or order, which requisition or order he shall file as a supporting voucher to his issue account. 81. He shall on no account permit any servant of the Institution or any other person to enter his office or the store of the Institution except in the delivery and issue of stores or on business. 82. He shall reside on the premises and not absent himself from duty without the sanction of the Chief Medical Officer and Director, 83. He shall have the general supervision of the Storeman, the Mason, the Carpenter, Bedmaker, Cooks, Bathman, Labourers, Scourers, Gatemen and Latrine Cleaner. 14 84. He shall see that they are attentive to their duties and respect- ful in their demeanour to every one in the Institution. That they enter upon their respective duties at 6 a.m. and that they do not leave the premises on any pretence before the hour of 6 o'clock p.m. unless when sent out on business, or when granted leave by the Chief Medi- cal Officer and Director, or in his absence by the Senior Medical Officer. 85. He shall see that the yards, sheds, tanks, earth-closets, kitchen, and all other departments are kept clean; that the Wards are pro- perly cleaned out daily, and the outside walls lime washed as often as may be found requisite; that the drains, earth-closets, and all places likely to emit unpleasant odours are regularly examined and disinfected; that the iron bedsteads are kept in an effective state ; that the mattresses and sackings are clean and in good condition; that they are regularly washed and returned to his custody. He shall also see that each Ward is supplied with its complement of beds. 86. He shall take charge of the clothing brought in by male pa- tients and enter particulars of same in a book to be kept by him for the purpose; he shall see that they are washed and properly labelled with the name of the patient and carefully put away until the patient is discharged when he will diliver them up. He shall be held respon- sible for any loss of clothing which shall have been delivered over to his custody. 87. He shall maintain order and decorum among the servants and patients and shall visit the Wards and other parts of the Institution frequently during the day, and at uncertain hours of the night, and shall in the absence of the Chief Medical Officer and Director report to the Medical Officer on duty any improper conduct or violation of the Rules. 88. He shall see that the culinary department is properly conducted; that cleanliness is observed by the Cooks; that no more fuel wood is used in the kitchen than is actually required; that the patients are not permitted to enter the kitchen, and that Servants or Nurses are not allowed to loiter therein. 89. He shall see that the Night Gatemen enter upon their duties at 6 o'clock p.m. and that they do not leave in the morning until re- lieved by the Day Gateman. 90. lie shall deliver daily to the Cook the diets ordered for the patients and shall see that these are properly cooked and served at the appointed hours; he shall take care that none are surreptitiously con- cealed or carried away by any person whether connected or uncon- nected with the Institution ; that the mess tables, benches, and other articles of furniture are properly cleaned and kept in serviceable 15 condition, and that the Wards are supplied with a sufficient quantity of water for drinking and ablution purposes. 91. He shall walk round the Wards daily while the patients are at their meals and during the time that Visitors are admitted and shall see that order is observed and loud talking avoided. 92. He shall report daily any improper delay in the delivery of the dietary or any infringement of the Rales by the Nurses or Cooks. 93. He shall on the death of a patient make all necessary arrange- ments for the funeral and postmortem examination, or for the remo- val of the body by the friends, and shall inspect the Mortuary every evening and see that it is clean and properly secured for the night. 94. lie shall see that the gates of the Hospital are opened and shut at the appointed hours and shall receive the keys from the Porter, and be responsible that the lamps are lighted at dusk, lowered at 8 o'clock p.m. and extinguished at dawn. 95. He shall on each Sunday on the ringing of the bell see that the convalescent patients are in attendance at a quarter of an hour before the time fixed for divine service, namely, 3 p.m. 96. He shall satisfy himself that the Contractor carefully removes the whole of the night soil from the bin, and covers it thoroughly with dry "sifted earth after placing it in the cart and previous to remo- val from the premises through the south gate. 97. He shall be responsible that this duty is performed nightly and not before 10 p.m. under the direction of the Night Gateman. Assistant Warden. 98. The Assistant Warden shall be held responsible for the proper distribution of the diets, extras and stimulants delivered to him by the Issuer. 99. He shall prepare a duplicate list daily of all extras and liquors ordered, shewing the name of each individual for whom ordered and the respective quantities drawn ; one copy he shall hand to the Issuer and the other copy shall be placed on the table of the Chief Medical Officer and Director for his information. 100. He shall visit the Wards daily and ascertain personally if the extra diets, wines, liquor and spirits issued on the authority of the Medical Officers have been given to those patients for whom they were ordered, and shall certify the fact on one copy of the wine and liquor list for the day and shall place the same before the Chief Medical Officer and Director each day. 101. He shall attend at the admission of male patients into Hos- pital and shall see that they are washed before they are sent up to their respective Wards and that their hair is properly cut, unless 16 otherwise ordered by the Medical Officers ; he shall superintend the application of warm and vapour baths to the male patients, and shall perform such other duties about the Wards, in connection with the sick, in accordance with the instructions that may be isued from time to time ; he shall also report any irregularity that may come under his notice. 102. He shall prepare daily a list of the number of beds vacant in each Ward, which shall be placed on the table in the Taking-in Room for the information of the Medical Staff. 103. He shall on the admission, discharge or death of any patient, furnish the Clerk and Purveyor with a return of the diets prescribed and of the Ward to which he or she belongs. 104. He shall assist the Warden in the general supervision of the labourers and servants. 105. He shall collect daily and hand to the Hall Porter the tickets of those patients who may be discharged at the Medical Inspection, andobtain from the Warden the clothing of each male patient when discharged. 106. He shall assist the Warden in preserving order in the Wards when Visitors are present. Porter. 107. The Porter shall at all times be stationed in the Hall near the principal entrance to the Hospital; he shall not permit any patient, nurse or labourer to leave the Institution, unless by a ticket of per- mission, nor suffer any one to enter the gate who may have been out on leave, if on his return he be drunk, riotous or disorderly. 108. On the admission of a patient by direction of one of the Medi- cal Officers he is immediately to enter his or her name, age and par- ish, in a Register to be kept by him, and then to hand such patient over to the Under Warden. 109. He shall take charge of all property and moneys brought into Hospital by patients, and enter the name of patient and descrip- tion of property in a book to be kept for the purpose, and shall then hand over the same to the Clerk and Purveyor for safe keeping, who will at the time acknowledge their receipt by countersigning the en- tries in the book. 110. He shall each morning take charge from the Night Gateman of any money or valuables intrusted to him by patients admitted during the night, and shall question each patient as to the correctness of the Gateman's return. 111. He shall not permit any person to visit any of the patients, except during the appointed hours, without the sanction of the Medi- cal Officers; he shall see that no Visitor take in to any of the patients 17 anything which is forbidden by the Rules and Regulations; he is to examine all patients leaving the Hospital or returning from absence on leave, for the purpose of ascertaining that they do not carry away any of the Hospital property, nor introduce any forbidden articles. 112. He shall see before Visitors are allowed inside the gates of the Hospital that the south gate of the Female Hospital is locked and that a labourer is stationed in the centre walk of the Hospital to prevent visitors going from one division of the Hospital to another. 113. He will permit only one Visitor to a patient at a time: he will not admit any Female Visitors to any seaman from the shipping, without reference to the Medical Officer on duty. 114. He must examine the baskets or other packages or parcels of the Labourers and Nurses, and other persons when they come to, and are about to retire from the Hospital, in order to ascertain that they neither introduce improper books or fobidden articles of any kind, nor carry away any Hospital property. 115. He is to enter daily in the Register kept by him for the purpose, the names of all patients who die or are discharged from the Institution, with date of death or discharge. 116. He shall daily prepare, in duplicate, a return of patients admitted, discharged and died, together with a return of the num- ber of empty beds, one copy of which he shall place on the table in the Chief Medical Officer's and Director's Office, and the other in the Taking-in Room. 117. He shall direct a bell to be rung at 6 o'clock p.m. at which hour the gates of the Institution shall be locked, and the keys shall then be handed by him to the Warden. 118. He shall ring a bell for Divine Service at such hour as may be" appointed on each Sunday. Dispenser. 119. The Dispenser shall reside on the premises and must not on any account leave them without the permission of the Chief Medical Officer and Director or in his absence of the Senior Medical Officer, or of the Resident Medical Officer on duty. 120 He shall have charge of and be responsible for all medicines in the Store and Dispensary of the Hospital, under the supervision of the Junior Resident Medical Officer. -.. . , 121 He shall prepare a return of the stock of medicines on hand half-yearly, also such indents for medicines as may from time to time be required, which return and requisition he shall submit for the ap- proval of the Junior Resident Medical Officer previous to its being laid before the Chief Medical Officer and Director for transmission to the Island Medical Department. 18 122. He shall be responsible for the proper compounding and pre- paration of medicines at all hours of the day and night, according to the prescriptions of the several Medical Officers, and he will see that the medicines ordered for in-door patients are promptly prepared and delivered to the Head Nurses for distribution. 123. He shall superintend the out-patient department and the preparation of all medicines prescribed by the Resident Medical OffU cers for out-door patients, and shall file all such prescriptions in the Dispensary for future reference. 124. He shall have the medicines properly arranged in the Dis- pensary and keep such drugs as strychnine, atropine, digitalis, cor- rosive-sublimate, arsenic, and other poisons locked up in a cupboard, the key of which must never be out of his possession; and he shall also see that the several medicine cupboards in the Wards are properly arranged and supplied with medicines for the use of the Medical Officers in case of emergency. 125. He shall be held responsible for the proper behaviour of the Dispensary Students and is required to see that the Rules laid down for their guidance are strictly complied with. 126. He shall report any disobedience of orders or impropriety of conduct on their part to the Chief Medical Officer and Director. 127. He shall open the Dispensary for the transaction of ordinary business at 7 a.m. and close it at 5 p.m, unless otherwise ordered by the Chief Medical Officer and Director. Assistant Dispenser 128. The Assistant Dispenser shall be subordinate to the Dispenser and shall assist him in the performance of his duties ; he shall com- mence his duties at 7 a.m. and not leave the Hospital before 5 o'clock p.m., unless permitted to do so on leave sanctioned by the Chief Medi- cal Officer and Director, or in his absence by the Senior Medical or Resident Medical Officer on duty. Dispensary Apprentices. 129. Young men wishing to become Dispensers will, if approved of by the Chief Medical Officer and Director, be indentured for a period of three years on their presenting to the Chief Medical Offi- cer and Director testimonials of good moral character and sufficient educational proficiency; and on their paying to the funds of the Hospital the sum of five pounds. 130. The course of instruction will comprise practical teaching in the compounding and dispensing of medicines, in Elementary Chemistry, Pharmacy and Materia Medica, as well as in dressing and bandaging. 19 131. During the second or third year of their apprenticeship they will, should the Superintending Medical Officer so direct, be required to attend at the Drug Store of the Island Medical Department for instruction in the method of keeping and rendering the medical ac- counts and returns. 132. On the expiration of the term of apprenticeship each Appren- tice will be required to pass an examination in the subjects of study. The examination shall be oral and written, and if the result of the examination be satisfactory he will be furnished by the Chief Medical Officer and Director with a certificate of qualification, the possession of which will render him eligible for employment in the Public Gene- ral Hospitals of this Island or other Public Institutions. 133. They shall attend at the Dispensary daily from 7 a.m. to 5 p.m., one hour being allowed for breakfast, and not leave the Institu- tion without permission from the Chief Medical Officer and Director, or in his absence from the Senior Medical Officer or Resident Medical Officer on duty. 134. They shall strictly confine themselves to their duties, and on no account loiter about the square or visit the Wards of the Hospital, unless specially sent by the Dispenser. 135. In the absence of the Dispenser or of the Assistant Dispenser they will prohibit any person entering the Dispensary, except the Medical Students or Servants of the Institution sent on special service or employed therein. 136. They shall not under any circumstances deliver medicine to any person whatever, without the express order of a Medical Officer or of the Dispenser or Assistant Dispenser. 137. They are expected under every circumstance to conduct them- selves with civility towards each other, as well as towards the out-door patients and all the Officers or Servants of the Institution with whom they may come in contact, and on no account will abusive lan- guage, loud talking, or disobedience of orders be permitted. 138. All applications for leave of absence must be made through the Dispenser to the Chief Medical Officer and Director. 139. Any application for extended leave of absence must be accom- panied by a written request from the Apprentice's Parent or Guardian. 140. All absences from sickness, beyond a period of 7 days, unless the Apprentice is attended by a Medical Officer of the Institution, must be vouched for by medical certificate. 141. The period during which any Apprentice may be absent from the Hospital, on suspension, will not be counted in his term of Inden- ture. 142. The Chief Medical Officer and Director may suspend or dis- 20 miss any Apprentice for misconduct, for repeated breaches of the Rules, or persistent inattention at Lecture or during hours of study, and if dismissed his entrance fee will be forfeited. Dresser. 143. The Dresser shall reside on the premises and must not on any account leave the Institution withdut the permission of either the Chief Medical Officer and Director or of the Senior Medical Officer, or in their absence of the Resident Medical Officer on duty. 144. He shall keep in perfect order, under the direction of the Junior Resident Medical Officer, all the surgical instruments and other apparatus belonging to the Institution. 145. He shall accompany the Medical Officers during the medical inspection round the Wards, and shall have with him such instru- ments as may be required by them. He shall be in attendance at all surgical operations; and on the occasion of any operation he shall carefully arrange in a tray the instruments that may be re- quired, with all other requisites, and shall place them in readiness in the Operating Theatre. 146. He shall attend to the dressing of all surgical cases and report immediately to the Medical Officers whenever any unfavourable change occurs ; he shall perform this duty morning and evening and as many times during the day as may be deemed necessary. 147. He shall see that a sufficient supply of bandages is kept rolled and ready for use, and that lint, sponges, oil cloth, plaster, ligatures and basins are at all times in readiness in the Surgery ; he shall be held responsible that these and any surgical instruments in the Hos- pital can be produced at a moment's notice by night or day. 148. If a patient be brought into the Hospital at night he shall immediately report the circumstance to the Medical Officer on duty so that the case may be promptly attended to. 149. He shall attend daily at the taking in of patients in the out- door patient department and shall, under the direction of the Medical Officers, dress all out-patients who may require his services. Assistant Dresser. 150. The Assistant Dresser shall be subordinate to and shall assist the Dresser in the performance of his duties ; he shall commence his duties at 6 a.m. and not leave the premises before 6 o'clock p.m. unless permitted to do so on leave sanctioned by the Chief Medical Officer and Director, or in his absence by the Senior Medical Officer or Resident Medical Officer on duty. 151. He shall assist at all post-mortem examinations in the Mor- tuary. 21 Head Nurses. 152. The Head Nurses shall administer the medicine prescribed by the Medical Officers, and see that the nourishment ordered is regularly distributed and taken ; they will be subordinate to the Matron ; they shall be kind and attentive in the discharge of their duties. They shall inform the Medical Officers immediately they observe any change for the worse in the state of any patient; they shall superintend the dressing of blisters, setons and application of liniments. 153. They shall take care that the patients swallow their medicines and stimulants, and they are not to leave them until satisfied they have done so. 154. They shall see that the nourishment directed by the Medical Officers has been properly cooked, and that it is administered to the patients in a fit and palatable state, at such intervals as may be or- dered ; they shall be careful that each patient receives the particular diet prescribed, and that no waste or exchange of nourishment be allowed to take place; they shall obtain from the Under Warden daily any wines or liquors ordered, and shall distribute them carefully to the patients as they may be directed. 155. They shall see that the Wards are kept clean; that silence and order are preserved in them, and shall report to the Medical Offi- cers any improprieties that may take place in their respective Wards. 156. Whenever any iron-bedsteads require cleaning they shall in- form the Warden at an early hour in the morning. They shall im- mediately, on the death of a patient, inform the Warden thereof, in order that the body may be conveyed to the Mortuary. 157. They shall prepare a list every evening of patients who are to take medicines and extra nourishment during the night, which they shall deliver every evening at 6 o'clock to the Night Nurses, and they shall furnish them with all information relative to those patients who may require the most strict attendance during the night. When about to deliver over charge to the Night Nurses, they shall see that the medicines and nourishment directed to be given during the night are prepared and in possession of such Nurses. 158. When a female patient has been admitted, she shall be received by the Head Nurse of the Ward, whose duty it is to see that she be bathed in warm or cold water as may be ordered. 159. The Head Nurses of the female division shall take charge of the clothing brought in by female patients or children; enter particu- lars of same in a book to be kept by them for the purpose, which they will present to the Matron to be countersigned; they shall take care that they are washed, properly labelled with the name of the pa- tient and handed to the Matron to be put away until the patient is dis- 22 charged, when they will receive them from the Matron for delivery to the owner. They will be held responsible for the loss of any pa- tient's clothing which may have been delivered to their custody. 160. They shall have charge of all books provided for the patients and shall keep a correct list of them ; they shall distribute and collect them from time to time as may be requisite, and take care that none are lost, injured or destroyed by the patients. They shall not per- mit any books or papers to be taken into the Wards by any Visitor, unless permission be previously granted by the Chief Medical Officer and Director. 161. They shall report without delay to the Warden the name of any patient of the Church of England who may express a desire to see the Chaplain, and also the names of any patients who may desire to see a Minister of their own Denomination, in order that such Chap- lain or other Minister may be immediately sent for. 162. They shall see that the Under Nurses remove out of the Wards all plates, pans, knives and forks, spoons, &c, immediately after the patients have finished their meals, and that they clean and return the same to the respective Wards. 163. They shall draw by7 requisition on the Matron all articles of clothing and bedding required for use in their respective Wards, and they will be held responsible for the loss of any articles under their care. 164. They shall see that the Under Nurses and Servants are atten- tive to their duties, and kind to the patients in their respective Wards. They are also required to see that the Rules are obeyed, and order and decorum maintained among the patients, and to report to the Medical Officers any irregularity that may occur. Nurses in Training. 165. The Nurses in Training shall attend the Hospital daily from 8 a. m. till 5 p.m. 166. They shall accompany the Medical Officers in their morning visits through the Wards, and they will observe especially the direc- tions given with regard to the diet and regimen of the sick, as well as the instructions about the administration of medicinss which may be prescribed. 167. They shall be under the control and command of the Medical , Officers of the Hospital, and shall carry out zealously every order or direction which they may receive from them. They shall also be con- sidered to be under the supervision and authority of the Matron and the several Head Nurses of the Hospital, from whom they will re- ceive instructions from time to time as to their employment and duties in the Wards. 23 168. They shall give practical assistance to the ordinary Nurses of the Hospital, in every department of their duty; they will attend di- ligently to the wants and requirements of the several patients, and be careful that the medicines are regularly and punctually administered. 169. In the event of a prevalence of yellow fever or of any other epidemic disease, by which an unusual number of severe and danger- ous cases of sickness might be congregated in the Hospital, these Nurses may be required to be present in the Wards during the entire day, and if necessary throughout the night. Their stay in the Institu- tion, and the duties which might devolve upon them on these occa- sions, will be regulated as the Medical Officer may think proper. 170. They shall have the privilege of attending all surgical opera- tions in the Theatre or Operating Room of the Hospital, and they will always give their special attention to the management and after treatment of such cases. 171. They shall be governed by and be subject to the General Rules of the Hospital, so long as their service in it may continue. Night Nurses. 172. The Head Night Nurses shall take charge of the patients at the hour of 6 o'clock p.m. daily and give up their charge at 6 o'clock a.m. after properly performing their duties. 173. They shall receive a list from the Head Day Nurses of such patients as require particular attention, and administer their medi- cines, nourishment, wines or liquors, according to the directions they receive; they shall take care that the Head Day Nurses provide them with the medicines, nourishment and stimulants so required; and they shall pay attention to the patients generally, but more particu- larly to those whose names are on the list handed to them, 174. They shall report in the morning to the Head Day Nurses any changes they may have noticed in the patients during the night. 175. The Under Nurses shall have the different utensils and slop- pails cleaned before leaving. 176. The Under Night Nurse attending to Luke Ward shall an- swer all calls at the gate during the temporary absence of both Night Gatemen. Messenger. 177. Shall commence his duties at 7 a.m. 178. He shall take alternate Sunday duty with the Porter, re- lieving that Officer at 9 a.m. 179. He shall be careful that" all letters, requisitions and other documents, intrusted to him are delivered as directed without delay, 180. He shall see that the tables and desks in the Administrative 24 Offices are properly dusted, and that there is always a proper supply of ink and writing materials ready for use. Office Cleaner. 181. She shall commence her duties at 7 a hi. and be under the immediate control of the Matron. 182. She shall not leave the premises until the Administrative Offices and the stairs leading to them have been properly cleaned. Head Cook and Assistant. 183. They shall commence their duties at 6 a.m. and not leave the premises until 6 p.m., unless permitted to do so. 184. They shall obey the directions of the Warden in preparing and cooking all food or nourishment for patients. 185. The Head Cook shall have charge of and be responsible for all cooking utensils, which must be kept clean and fit for immediate use. 186. He shall not allow any waste or misapplication of the food, provision or stores of any kind which are issued to be cooked for the patients ; and he shall have all food so cooked ready to be issued ac- cording to the Rules prescribed for that purpose. Day Gateman. 187. He shall commence his duties at 6 am. and not leave his post until 6 p.m. unless permitted to do so. 188. He shall keep the gate constantly closed, and not allow any person to loiter about it. 189. He shall not allow any Sub-Officer, Nurse, Under Nurse, La- bourer or other Servant to go out of the Hospital during duty hours, without a pass from the Warden or Matron. 190. He shall refer to the Porter all persons applying at the gate of the Hospital, and he shall not allow any parcels or packages to be brought into or carried out of the Hospital without the knowledge of the Porter. Night Gateman. 191. He shall commence his duties at 6 p.m. and not leave the premises until relieved at 6 a.m. by the Day Gateman. 192. He shall lock the gate at 6 p.m. and open it at 6 a.m. 193. He shall visit the detective clock in the Operating Theatre and also the Wards every hour during the night from 10 p.m. to 5 a.m., entering his visits in the Ward Journals. 194. He shall superintend the removal of the night soil by the Con- tractor and shall see that the whole of it is carefully removed and 25 covered over with sifted dry-earth after being placed in the cart, and previous to removal from the premises, through the south gate which he shall afterwards lock. 195. He shall whenever required to leave the north street gate place the Assistant Night Gateman there and the Under Nurse of Stephen Ward in the Assistant Night Gatcman'p place until his return. 196. When it is necessary for him and his Assistant to attend in any other part of the Hospital he shall place the Under Nurse of Luke Ward in his place, and the Under Nurse of Stephen in that of his Assistant. 197. He shall on returning to his post relieve these servants and see that they at once return to their respective duties. 198. At 8 p.m. and 5 a.m. he shall attend at the Bin and super- intend the emptying of the slops and contents of the earth-closets by the several Under Nurses. 199. He shall light the lamps at dusk, brighten them at dark, lower them to an inch flame at 8 o'clock, and extinguish them at dawn. 200. He shall report at once to the Warden any irregularity that may occur during the night. 201. He shall take charge of, and hand over to the Porter the next morning, any money or valuables brought into the Hospital by pa- tients admitted during the night. Assistant Night Gateman. 202. He shall commence his duties at 6 p.m, and not leave the premises until 6 a.m. unless permitted to do so by the Warden. 203. He shall be stationed under the buildings and attend to the patients there as required. 204. He shall assist the Night Gateman and perform such duties as may be required of him during the night. The Carpenter, Mason, Bedmaker, Bathman, Labourers, Under-Nurses, Storeman, Scourers, and Closet Cleaner. 205. Shall commence their duties at 6 a.m. and not leave the premises before 6 p.m. (except the Tradesmen and Storeman who will be relieved of duty at 5 p.m.) unless sent out on business or permitted to go on leave. 206. They will receive and be required to obey implicitly all orders from their Superior Officers. 207. They are expected to be kind and civil to the patients, to be faithful in the discharge of their duties, and to report to the Warden, or in his absence to the Under-Warden, for the informa- tion of the Chief Medical Officer and Director, any irregularity they 26 may observe either in the Wards or within the premises of the Insti- tution. Patients. 208. The patients are divided into two classes, viz:—In-door patients admitted within the Wards of the Institution and out-door patients receiving medical advice and medicines at the Dispen- sary of the Institution. 209. Applicants for admission as in-door patients of the Hospital will be seen daily by the Medical Officers between the hours of 10 and 11 o'clock a.m. 210. Applicants for medical advice and medicines as out-door patients must bring with them a ticket of recommendation from the Custos of Kingston or the Almoner, or such other persons as the Governor may nominate and appoint to grant tickets. 211. They will be examined and prescribed for by the Resident Medical Officers at noon as follows : — Mondays and j For Women and ChMreQ Thursdays J Tuesdays and 1 For Men Fridays J 212. All cases of accident or emergency will be admitted at any hour of the day or night by the Resident Medical Officer on duty. 213. No seaman, hired, articled, or apprenticed to any vessel, and no person apprenticed to any person, shall be admitted into the Hos- pital except on occasion of serious accident or other extreme emer- gency until the consignee of such vessel, or the proprietor or agent of such estate, or the master or employer of the person indentured or apprenticed, shall have given a letter of guarantee to the Chief Medical Officer and Director undertaking to the extent of £20 for the payment of the hospital dues at the rate of 2s, 6d. per diem for each seaman and Is. 6d. per diem for each apprentice, and for payment also of funeral expenses in case of death. 214. All persons (other than articled seamen, indentured immi- grants or apprenticed servants) who are admitted into the Wards of the Hospital for medical treatment as in-door patients, who are not wholly destitute of means, may be required to contribute towards their maintenance in the Hospital by payment of such proportion of the hospital dues fixed by Law as may be determined by the Chief Medical Officer and Director. 215. The name, age, occupation, residence and nature of com- plaint of every patient received into the Hospital shall be recorded in the Register of the Institution. 27 216. If any patient at the time of admission be possessed of any money, watch or other valuable property, the same shall be taken possession of by the Porter and full particulars thereof entered in a book to be kept by him, called "The Patients' Property Book," which entry shall be attested by the Clerk and Purveyor. The money or other property brought in by a patient will be liable for the medi- cal attendance, medicine and support of such patients, and may be sold by the Chief Medical Officer and Director to defray the same. Any surplus moneys or remaining property to be handed over to the patient upon his discharge, or in case of his death to the parties legally entitled thereto, upon application. 217. When a male patient has been examined and admitted for treatment within the Wards, he shall be received by the Under Warden whose duty it is to see that he be bathed in warm or cold water as may be ordered. His hair shall be cut and his beard be removed, if necessary. He shall be placed in the Ward to which he is appointed. His own clothes delivered to the Warden, who will Bend them to be washed and kept in safe custody until he is dis- charged. He shall be dressed in a clean suit of the Institution's clothing, namely, a shirt and a pair of trowsers ; unless he has the permission of the Medical Officers to wear his own clothing. 218. Female patients on admission will be handed over to the Head Nurses in charge of the Wards, whose duty it is to see that they are bathed in warm or cold water as may be ordered. 219. The patients are expected to conduct themselves with civility towards each other, as well as to the Officers, Nurses and Servants. On no account will abusive or profane language, loud talking or dis- obedience of orders, be permitted. 220. No patient shall be allowed under any*circum§tance to smoke tobacco or other weeds within the Wards of the Hospital, but under the sanction of the Medical Officers a patient may be permitted to smoke during such time, and in such part of the premises, as may be appointed for that purpose. 221. Pipes and tobacco will be issued only by the Issuer on the written permission of the Medical Officers. 222. Upon the ringing of the bell at half past seven o'clock p.m. the patients are to retire to their Wards, and on the ringing of the second bell at eight o'clock they shall retire to their beds for the re- mainder of the night, during which no talking is to be permitted, nor any walking from one Ward to another, or about the piazzas or square. The Night Nurses are expected to report in the morning through the Head Nurse of the Ward, the names of the patient who 28 may have broken this Rule. All lights are to be lowered at eight o'clock unless orders are issued to the contrary. 223. W hen any money or property which should have been handed over to the Porter is found concealed on or about the bed or person of a patient, it will be the duty of the Nurse to report the fact to the Warden, who will in presence of the Nurse take the property so found and deliver it to the Clerk and Purveyor for safe custody, and to be entered into the Patients' Property Book. 224. Upon the ringing of the bell at six o'clock a.m., patients who are convalescent, are expected to rise from their beds and leave their Wards, unless otherwise directed by the Medical Officers; and such patients are on no account to lounge about the Wards or Piazzas whilst the Nurses are engaged in cleaning them. 225. Convalescent patients who have no objection are expected to be present at Divine Service every Sunday when the Chaplain at- tends. 226. No patient shall be permitted to enter the Kitchen, Dispen- sary, Store Rooms, Officers' Quarters or any other Ward than that which is assigned to him or her. 227. The dieting hours for patients are 8 o'clock a.m. breakfast, 2 o'clock p.m. dinner, 5 o'clock p.m. tea; extra nourishment at all hours when ordered. 228. The following service of bells will be observed. Hour. Service. No. of Bells. 6 A.M. Duty Bell 4 7.30 " •Bread • 7 8 Breakfast 8 9 " Issue of Stimulants 2 a .( Labourers go to Breakfast a 10 " Attendance of Nurses at Kitchen and return of Labourers to duty 4 11 Beef Tea 6 12 Noon. Store open 1 1 P.M. Rice Pap 2 2 Dinner 4 3 Beef Tea and Store open 6 5 Supper 2 6 Dismiss and relief of Nurses .... N.B. The Dispensary to ring whenever 4 Medicines are ready for the Wards. 5 29 229. When husband and wife are both inmates of the Hospital they are not to be permitted to visit each other, except between the hours of 4 and 6 p.m , and then only with the special leave of the Medical Officers. 230. No patient will be permitted in any way to employ his time for his own benefit, or carry on any traffic within the walls of the Institution. 231. Patients who are dissatisfied with the treatment they are re- ceiving, or the behaviour of Nurses or Attendants, or the quality of their food, are expected to represent their grievance to the Medical Officers of their respective Wards; they may however address their complaints direct to the Chief Medical Officer and Director ; to any member of the Board of Visitors, or to the Governor of the Colony, if they desire to do so. 232. Any infringement of the Rules by patients will subject the aggressor to punishment by alteration of diet or to summary dismissal from the Hospital, as may be determined by the Chief Medical Offi- cer and Director, the nature of offence and extent of punishment being in either case, entered in 'the Journal of the Division to which the patient belongs. Ministers of Religion and Persons Accredited by Them. 233. Will be permitted to visit patients of their own faith at all times, except when the Medical Officers consider such visit would be injurious to any particular patient. Visitors to Patients. 234. Will be admitted on Sundays and Wednesdays between the hours of 10 and 11 a.m. and 4 and 5 p.m., after which hour no Visit- or will be allowed in the Wards unless by special permission of the Chief Medical Officer and Director or of arty of the Medical Officers. 235. Visitors under urgent circumstances will be admitted to see their friends on all days of the week between the hours of 10 and 11 a.m. and 4 and 5 p.m. and at any other reasonable hour on the permis- sion of the Resident Medical Officer on duty. 236. Visitors will not be permitted to take into the Wards any spirituous liquors or other articles. 237. Visitors to patients will not be admitted unless they are de- cently attired. General Rules, 238. No Officer, Attendant, Nurse or Servant of any grade, shall take any fee, gratuity or reward, directly or indirectly, from any Contractor, Tradesman or other person dealing with the Hospital under pain of immediate dismissal. 30 239. No Officer, Attendant, Nurse or Servant shall receive from any patient, whilst resident in the Hospital, or from the friends of such patient, any fee, gratuity, or reward. Any patient or the friends of any patient desiring to present any Officer, Nurse, or Servant, with a testimonial for special or peculiar services rendered maybe permitted to do so after the discharge of such patient from the Hospital on obtaining the sanction of the Chief Medical Officer and Director. 240 No Visitor or other person shall be permitted to bring into the Hospital any fire, matches, pipes, tobacco, spirits, wines, fermented liquors or other articles of diet, for the use of any patient. 241. No Huckster or Pedlar shall be permitted within the gates of the Hospital with out the express sanction of the Chief Medical Officer and Director, and messengers to persons connected with the Hospital shall not be permitted beyond the Porter's Lodge. 242. No Officer, Nurse, or Servant will be permitted to smoke to- bacco or other weeds in the Institution, but the Labourers or Nurses, when engaged in any noisome occupation, may be permitted to do so under and by the sanction of the Warden. 243. Application for leave, except in cases of emergency, must be solicited the day before it is required, and such applications be- fore being presented to the Chief Medical Officer and Director for approval must be initialled by the Senior Medical Officer, or in his absence by the Resident Medical Officer on duty and by the head of the division in which the person is employed. 244. The Sub-officers and Servants shall relieve each other on al- ternate Sundays, if circumstances will permit. 245. The Tradesmen and Scourers will not be required to attend at the Hospital on Sundays. 246. The following Government Holidays will be observed when- ever such observance does not interfere with the proper working and good order of the Institution :— (1) New Year Day (2) Ash Wednesday (3) Easter Monday (4) Good Friday (5) Queen's Birthday (6) Christmas Day 247. All Attendants and Servants shall subscribe to the following obligation on their employment permanently in the Public Hospital. 31 I have read (or have heard read) the Rules of the Public Hospital. I have had delivered to me a copy of the Rules specially laiddown for my guidance as I hereby promise strictly to obey all such Rules; to avoid gossip- ing about the affairs of the Hospital or its inmates ; to be careful of its property ; to promote as far as I am able, its objects, and to endea- vour by my own good conduct and demeanour to sustain the respect- ability of its Staff. I consider myself bound in emergencies, or should circumstances require my doing so, to perform any duty assigned to me by the Officers of the Institution, in its service, although such duty may not be of a nature which I usually perform. If anything improper is done in my presence, or to my knowledge in the Institu- tion, I consider myself bound, and I pledge myself, to mention it to the Chief Medical Officer and Director. I agree to give two weeks' notice should I wish to give up my situa- tion ; but I acknowledge the right of the Chief Medical Officer and Director to suspend me or to discharge me without any previous notice for acts of unkindness to patients, intemperance, transgression of the Rules, or disobedience of orders, when proved against me; my wages being forfeited, if my conduct compromises the character of the Insti- tution. Note—Any Attendant or Servant who is known to frequent any gambling-houses or grog-shop3 in the neighbourhood of the Hos- pital will be considered to have transgressed the Rules. CIIAS. B. MOSSE, S.M.O. The foregoing Rules and Regulations were established by me in Privy Council this 4th day of April, 1881. A. MUSGBAVE, Governor. ARMED FORCES MEDICAl LIBRARY WASHINGTON, 0 Q. t / \ • JL3.. Syrocuie, N. Y Stecklon, Col if. ra NLM001340855